Instrument for joining blood vessels



Dec. 27, 1960 KlYOSHl INQKOUCHI 2,965,900

INSTRUMENT F'oR JOINING BLOOD VESSELS Filed Sept. 14, 1959 3Sheets-Sheet 1 10 /5Z5 ,5 L E57. 15 I i 1-9 F1916 6 *B 10 Dec. 27, 1960KlYOsH] o ouc -n 2,965,900

INSTRUMENT FOR JOINING BLOOD VESSELS Filed Sept. 14, 1959 3 Sheets-Sheet2 1960 KIYOSHI INOKOUCHI 2,965,900

INSTRUMENT FOR JOINING BLOOD VESSELS Filed Sept. 14, 1959 s Sheeis-Sheets United States Patent INSTRUMENT FOR JOINING BLOOD VESSELS KiyoshiInokouchi, Fukuoka City, Japan, assignor to Risabnro Aoki, Tokyo, JapanFiled Sept. 14, 1959, Ser. No. 839,686

Claims priority, application Japan Sept. 30, 1958 6 Claims. (Cl. 150)This invention relates to the class of surgical instruments and moreparticularly to a forceps used for the joining of the blood vessels.

The instrument according to the invention is characterized by having twocoaxial pairs of forceps, one with a pair of semi-cylindrical enclosureson the tip of each leg for guiding staples of the Hotehkiss type paperfastener, and in each enclosure slides a semi-cylindrical plunger topush out the staples, and on each forceps a bell-crank with a long leveris provided to reciprocate the plunger, and the other forceps isprovided with a pair of semicylindrical anvils to bend staples. Further,there is attached a tightening bar with a hook on the end cooperating ataper-pin to adjust the distance between the faces of the tips of theforceps.

An object of this invention is to facilitate a mechanical joining ofblood vessels during surgical operations safely and surely without usingany thread but using staples. Because the existing method uses handsuture, the present invention reduces the time necessary for anoperation thus safeguarding a patient.

A further object of the invention resides in the provision of means forstapling the ends of blood vessels together during surgical operations.

Yet another object of the invention resides in' the provision of meansfor clampingly holding the ends of blood vessels securely so that theends of the blood vessels may be developed into flanges with respect toa stapling or stitching head and an anvil, whereby the ends of the bloodvessels can be securely stapled together without requiring their suture.

Still further objects and features of the invention reside in theprovision of a surgical instrument that is highly eificient inoperation, inexpensive to manufacture and produce, easy to use and whichmay be easily sterilized so as to be rendered germ free and safe forsurgical operations.

These, together with the various ancillary objects and features of theinvention which will become apparent as the following descriptionproceeds, are attained by this surgical instrument, a preferredembodiment of which has been illustrated in the accompanying drawings byway of example only, wherein:

Fig. 1 is a side elevational view of the instrument comprising thepresent invention;

Fig. 2 is a side elevational view showing the instrument with each pairof forceps in detached position relative to the other pair of forceps;

Fig. 3 is a partial front elevational view of the instrument in aposition for feeding staples;

Fig. 4 is a front view of the forceps in an open position;

Fig. 5 is a view similar to Fig. 3, but showing the forceps in positionfor receiving staples;

Fig. 6 is a front view of the invention in an open position forreceiving staples;

Fig. 7 is a horizontal sectional detail view as taken along the plane ofline VIIVII in Fig. 1;

Figs. 8, 9 and 10 are sectional detail views similar to Fig. 7 butshowing the invention during stages of operation thereof;

Fig. 11 is an enlarged elevational view of the stitching head;

Fig. 12 is an enlarged sectional detail view as taken along the plane ofline XII--XII in Fig. 1;

Fig. 13 is an enlarged sectional detail view of the plunger forming apart of the stitching head;

Fig. 14 is a plan view of the plunger;

Fig. 15 is a plan view of a staple used in the invention;

Fig. 16 is a side elevational view of a staple;

Fig. 17 is a side view of the tightener; and

Fig. 18 is a bottom view of the ti htener.

in the accompanying drawings like reference numerals are used todesignate similar parts throughout the various views. The surgicalinstrument according to the present invention includes a pair of forcepsA, B which have nippers 1, 1' and looped grips 2, 2', which open andclose with the pins 3, 3 as pivot points.

The tips of the nippers 1, 1 are bent slightly forward and a pair of thestitching heads lie opposite to each other. To each forceps A, B isdetachably attached a pair of pincers a, b by screws 35, and eachpincers can be opened and closed separately. Each forceps has aconnecting bar 4 or 4 at the tip of the root of the nippers,respectively, and the bar 4 is made to project out behind the nippersthrough the hole 5 when the two pairs of forceps are assembled together,with the bar 4', at the root of the nipper 1, projected out forwardthrough the holes 5' of the nipper 1. A threaded pin provided with ascale 7 penetrates across the bar 4', and is engaged with a nut 6 whichis held in the slot of the bar. This pin is threaded on an end thereof,and the other end of the pin is slightly tapered. As the faces of theforceps, between which the taper pin is positioned, are inclinedparallel to the taper of the latter the distance between the two forcepscan be adjusted by pushing out or withdrawing the taper pin with the nut6, and the forceps are kept parallel to each other.

A sliding tightener 10 with two guide holes 9 is attached to the nipper1' with two set screws 36 and is longitudinally adjustable. Thetightener has a fork at the tip, and this part is tapered to form wedge12. A wedge shaped notch 13 fitted with the fork end is cut on the endof the connecting bar 4. After the bar is inserted through the hole 5 sothat the end of the bar projects out of the rear face of the nippers,the fork 12 of the tightener it} is hooked and tightened, holding theforceps A, B at proper distance from each other.

The stitching head and the anvil are separately attached at the tip ofeach nipper of the forceps. The head C has a semi-cylindrical form, andtwo symmetrical head clamps are prepared on the ends of the nippers 1,1' respectively. By closing the nippers, the heads are coupled together,and a cylindrical hole 14 is completed. Each head C has asemi-cylindrical slide 15 in it, and holds a reciprocating plungerrespectively.

The chambers of the slides 15 in the heads C are connected to thesegmental openings 17 which are bored through the end surface of theheads against the anvils, and through these openings extend projections18 which push the stitching staples 19 in the chamber of the slide outof the openings.

The reciprocating motion of the plungers is obtained by gripping thelevers 20. The tips of the levers are bent in the shape of the letter Land projected inward a short distance, and the points of the L-shapedlever 21 are disposed against pits 22 of the plungers. The plungers 16are moved to-and-fro parallel to the axis of the cylinder in thechambers of the slides 15 by the swinging motions of the operatinglevers 20 and the L-shaped points 21.

The anvils d each have a semi-cylindrical form, and each anvil is fixedon the end of nipper 1 of the forceps B, and as the two anvils are setdirectly opposite to each other, the two anvils d cooperate to make acylindrical hole 14 similar to the hole that is made by the stitchinghead 14 and in alignment therewith.

On the face of the anvils d several segmental pits 25 are engraved toreceive the staples 19 which are pushed out by the plungers through theopenings, and to bend the legs of the staples after stitching the bloodvessel. The semi-cylindrical necks of the heads and anvils which arefixed on the tips of the nippers of forceps A and B are exposed betweenthe two forceps, and clamps 27 provided with semi-circular jaws fittedwith the outer surface of the necks are pivoted on the inside of thenippers 1 and 1 by screws 29.

The other ends of the clamps have slots 36, and the clamps are openedand closed by crank pins attached to the small bellcranks which aresupported swing-free on the nippers 1 or 1' respectively. As these jawsare fitted with the outer surfaces of the necks, the ends of the bloodvessels 2 and e which are developed between the faces of the heads andthe anvils after guided through the cylindrical holes and turned overthe necks, can be clamped or released at will.

The operations and actions of a constructed practical example of thisinvention are as follows:

The forceps A, a and B, b are opened separately. The staples 19 shown byFigs. 15 and 16 are charged in the openings 17 of the clamps C. The endsof the blood vessels to be joined e, e are guided through thecylindrical holes 14, 14 which are formed by the heads c, c and theanvils d, d, and held tightly with ihe pincers a, a and each end isdeveloped over the openings 17 of the heads or over the pits of theanvils respectively. The border of each blood vessel is turned over the'fiange 26 or the anvil, and in this state, is clamped firmly by theclamps 27 around the necks 26 in turning the handles 32 of thebell-cranks 33.

The forceps A and B are assembled together by inserting the connectingbar 4 and 4- through the hole 5 and 5'. The distance between the headsand the anvils is adjusted by screwing the taper pin 7 forward andbackward using the nut 6, and in sliding the tightener 10 the fork 12 ishooked on the bar, fitting with the wedge-shaped notch, to fix theforceps A and B firmly (Fig. 1). After this, the plungers 16 are pushedalong the slides in the chambers by gripping the handles 24 and 24 ofthe operating levers and 20 simultaneously. The staples are pushed outby the projections 18 at the end of the plungers, through the overlappedwalls of the blood vessels 2 and e, and bent inward by the pits 25engraved On the faces of the anvils d, and bind the two blood vesselstogether. After the blood vessels are joined, the claws 27 on theforceps A, B, a and a are opened, and the joined blood vessels e and eare released as shown in Fig. 10.

The joining of the blood vessels by this invention is performed withoutusing needle or sewing thread. The end of the blood vessels aredeveloped over the faces of the stitching heads and anvils which makethe cylindrical 4 patterns for the blood vessels to be joined, andturned over the flanges of the blood vessels, and clamped firmly withthe jaws of the claws about the necks.

The faces of the heads and the anvils are pressed to each other with thetightener, and the staples are pushed out by the plungers and stitch thedeveloped flanges of the blood vessels and join them together. By theremoval of the clamps and the anvils from the joined blood vessels, bothare separated in two pieces in opening the forceps. The operation ispursued very easily and surely, and the time required to join the bloodvessels is quite short compared to the usual handsewing method. As theoperation of this instrument is very easy, and yet the purpose describedabove is achieved, it can make a great contribution to medical science.

Various changes and modifications may be made without departing from thespirit and scope of the present invention and it is intended that suchobvious changes and modifications be embraced by the annexed claims.

Having thus described the invention, what is claimed as new and desiredto be secured by Letters Patent, is:

1. An instrument for joining blood vessels, comprising two pairs offorceps, one of said pairs of forceps having nippers each provided witha stitching head of semicylindrical cross section at the end thereof,each stitching head having plungers by which staples are pushed out,operating lever means engaging said plungers to reciprocate saidplunger-s, the other pair of said forceps having nippers each providedwith an anvil of semi-cylindrical cross section on the end thereof, andmeans connected to said pairs of forceps for adjusting the distancebetween said stitching heads and said anvils.

2. Instrument for joining the blood vessels described in claim 1, saidlast recited means including a sliding tightener provided with a fork onthe end thereof, and a taper pin inserted between said pair of forceps,connecting bars attached to said pair of forceps, said tightenerengaging said connecting bars to hold said pair of forceps in spacedrelationship determined by the position of said taper pin.

3. An instrument for joining the blood vessels described in claim 1,said nippers of said pairs of forceps being provided with clamps pivotedthereto, said clamps having semi-circular jaws, and bell-cranks pivotedto said nippers and said clamps for opening and closing said clamps.

4. A surgical instrument comprising two pairs of forceps, one of saidpairs of forceps being provided with semi-circular stapling heads, theother of said pairs of forceps being provided-with semi-circular anvils,means for holding said anvils in aligned spaced relationship to saidstapling heads, and means for actuating said stapling heads.

5. The surgical instrument of claim 4, including clamping means pivotedto said pairs of forceps for clamping a blood vessel and holding theblood vessel for stapling.

6. The surgical instrument of claim 5, including means on said pairs offorceps for separately actuating said clamping means.

No references cited.

